Treatment Guideline Chart

Multiple myeloma is a bone marrow disease characterized by the presence of malignant plasma cells, & abnormal serum &/or urine immunoglobulin secondary to clonal plasma cell expansion.

It accounts for 1-2% of all cancers worldwide & mostly affects patients at ages 65-74 years old.

Patient usually presents with bone pain & nonspecific symptoms, or due to abnormalities in laboratory exams.


Differential Diagnosis

  • Other plasma cell proliferative disorders
    • Include other plasma cell proliferative disorders that do not meet the criteria for multiple myeloma but may eventually progress into multiple myeloma
    • Solitary (isolated) plasmacytoma
      • Diagnostic criteria should include all of the following: Biopsy-confirmed solitary bone or soft tissue lesion with evidence of clonal plasma cells, normal bone marrow without any evidence of clonal plasma cells, normal skeletal survey and no abnormalities in CT and MRI except for a primary solitary lesion, and no evidence of end-organ damage (CRAB criteria) attributable to any plasma cell proliferative disorder
      • May progress into multiple myeloma (10% progression rate in 3 years)
    • Extramedullary plasmacytoma
    • Osteosclerotic myeloma (POEMS syndrome)
    • Waldenström macroglobulinemia
  • Light chain amyloidosis
  • Plasma cell leukemia
  • Heavy chain disease
  • Bone metastasis
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